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ATI Pediatrics Proctored Exam 2023 with NGN
1. When using the Ballard gestational assessment tool on a newborn, which of the following tests should be performed after the first hour of birth, allowing the newborn to recover from the stress of birth?
- A. Arm recoil
- B. Square window sign
- C. Scarf sign
- D. Popliteal angle
Correct answer: A
Rationale: The correct answer is Arm recoil. Arm recoil is slower in healthy but fatigued newborns after birth, making it best elicited after the first hour of birth when the baby has had time to recover from the stress of birth. This assessment helps evaluate neuromuscular maturity in newborns and is more accurate when performed after the initial recovery period. The other choices, Square window sign, Scarf sign, and Popliteal angle, are not specifically assessed using the Ballard gestational assessment tool and do not relate to the recovery period after birth.
2. What is the proper depth of chest compressions for a 9-month-old infant?
- A. 1/3 the diameter of the chest or about 1 1/2 inches.
- B. 1/4 the diameter of the chest or about 1 inch.
- C. 1/2 the diameter of the chest or about 2 inches.
- D. 1/3 the diameter of the chest or about 3/4 inch.
Correct answer: A
Rationale: When performing chest compressions on a 9-month-old infant, the proper depth is 1/3 the diameter of the chest, which equates to approximately 1 1/2 inches. This depth is crucial for effective cardiopulmonary resuscitation (CPR) in infants. Choice B, which suggests 1/4 the diameter of the chest or about 1 inch, is incorrect as it does not provide the recommended depth for infants. Choice C, stating 1/2 the diameter of the chest or about 2 inches, is too deep and may cause harm to the infant. Choice D, mentioning 1/3 the diameter of the chest or about 3/4 inch, is also incorrect as it underestimates the required depth for effective chest compressions on a 9-month-old infant.
3. When does the onset of type 2 diabetes typically occur?
- A. Occurs after pubertal onset in the majority of cases
- B. Occurs due to parental financial status
- C. Occurs in childhood
- D. Occurs after giving birth
Correct answer: A
Rationale: The onset of type 2 diabetes typically occurs after pubertal onset. It is more commonly diagnosed in adulthood, although it can also develop in younger individuals. Factors such as genetics, lifestyle, and obesity play a significant role in the development of type 2 diabetes.
4. A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
- A. Always store insulin vials in the refrigerator
- B. Adjust insulin dosage before exercise
- C. Presence of ketones in urine indicates a need for less insulin
- D. Systematically rotate injection sites
Correct answer: D
Rationale: Systematically rotating injection sites is crucial to prevent tissue damage and ensure optimal insulin absorption. This practice helps in preventing lipohypertrophy, a condition characterized by fat accumulation at injection sites, which can affect insulin absorption and lead to inconsistent blood glucose control. By rotating injection sites, the risk of skin and tissue damage is minimized, and insulin's effectiveness is maintained over time.
5. Before drying off the newborn after birth, which assessment finding should the healthcare professional document to ensure an accurate gestational rating on the Ballard gestational assessment tool?
- A. Amount and area of vernix coverage
- B. Creases on the sole
- C. Size of the areola
- D. Body surface temperature
Correct answer: A
Rationale: To ensure an accurate gestational rating on the Ballard gestational assessment tool, healthcare professionals should document the amount and area of vernix coverage before drying the newborn. Drying the baby after birth could disturb the vernix, potentially affecting the gestational age assessment. Assessing and documenting the vernix coverage beforehand enables a more precise evaluation using the Ballard gestational assessment tool. Choices B, C, and D are incorrect as they are not directly related to gestational rating on the Ballard assessment tool.
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